7.Which of the following statements accurately
describe the effects the patient’s medications
may have on surgical risk? (Select all that apply.)
a.Diuretics may precipitate hemorrhage.
b.Anticoagulants may cause electrolyte
imbalances.
c.Diuretics may cause respiratory depression
from anesthesia.
d.Tranquilizers may increase the hypotensive
effect of anesthetic agents.
e.Adrenal steroids may cause respiratory
paralysis.
f.Abrupt withdrawal from adrenal steroids
may cause cardiovascular collapse in long-
term users.
8.Which of the following are significant abnor-
mal findings related to presurgical screening
tests? (Select all that apply.)
a.An elevated white blood cell count, indicat-
ing an infection
b.Decreased hematocrit and hemoglobin
level, indicating bleeding or anemia
c.Increased hyperkalemia or hypokalemia,
indicating possible renal failure
d.Elevated blood urea nitrogen or creatinine
levels, indicating an increased risk for
cardiac problems
e.Abnormal urine constituents, indicating
infection or fluid imbalances
f.Increased hemoglobin level, indicating
infection
9.Which of the following nursing interventions
would be appropriate for a patient recovering
from a surgical procedure? (Select all that apply.)
a.Teach the patient to suppress urges to
cough in order to protect the incision.
b.Encourage the patient to take frequent shal-
low breaths to improve lung expansion and
volume.
c.Place the patient in a semi-Fowler’s position
to perform deep-breathing exercises every 1
to 2 hours for the first 24 to 48 hours after
surgery and as necessary thereafter.
d.Encourage the patient to lie still in bed
with the incision facing upward to prevent
putting pressure on the stitches.
e.Teach the patient the appropriate leg exer-
cises to increase venous blood return from
the legs.f.Encourage the patient to use incentive
spirometry 10 times each waking hour for
the first 5 days after surgery.Prioritization Questions
1.Place the following guidelines for teaching a
patient deep breathing in the order in which
they would be performed:
a.Ask the patient to inhale through the nose
gently and completely.
b.Place the patient in semi-Fowler’s position
with the neck and shoulders supported.
c.Ask the patient to exhale gently and
completely.
d.Repeat this exercise three times every 1 to
2 hours.
e.Ask the patient to place the hands over the
rib cage so he/she can feel the chest rise as
the lungs expand.
f.Ask the patient to exhale as completely as
possible through the mouth with lips
pursed (as if whistling).
g.Ask the patient to hold his or her breath for
3 to 5 seconds and mentally count “one,
one thousand, two, one thousand, etc.”CHAPTER 30 PERIOPERATIVE NURSING 181
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing:2.Place the following guidelines for teaching a
patient effective coughing in the order in
which they would be performed:
a.Ask the patient to “hack out” for three
short breaths.
b.Repeat the exercise every 2 hours while
awake.
c.Place the patient in a semi-Fowler’s position,
leaning forward and provide a pillow or
bath blanket to splint the incision.
d.Ask the patient to cough deeply once or
twice and take another deep breath.
e.Ask the patient to take a quick breath with
mouth open.
f.Ask the patient to inhale and exhale deeply
and slowly through the nose three times.
g.Ask the patient to take a deep breath and
hold it for 3 seconds.LWBK696-C30_p178-185.qxd 9/3/10 12:44 PM Page 181 Aptara Inc